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Different methods of relapse prevention

When newly clean and/or sober, an addicted person will have better chances of remaining abstinent from his or her drug of choice if he or she has an action plan to adhere to when he or she eventually encounters triggers or cravings. Experts agree that the main reasons for relapse include boredom, loneliness, interpersonal conflicts and intrapersonal perceptions of external stimuli (Marlett; Gordon 1985). Other triggers that could lead to a potential relapse include stress, encountering people or places related to previous addictive behavior, facing negative emotions or even just seeing the object of the addiction.

Using CBT for relapse prevention

Attending therapy and 12-step meetings will benefit a newly recovered individual in many ways; however, these support systems do not prevent urges or triggers that lead to a relapse. One of the most important aspects of sobriety is having a relapse prevention plan.

Cognitive behavioral therapy (CBT) is an effective therapeutic model that trains a patient suffering from addiction how to identify patterns of negative thoughts and worldviews in an effort to understand their emotions. A basic premise of CBT is that one’s thoughts control his or her feelings, which then determine one’s actions.

In order for an addicted person to abstain from a substance of choice, according to CBT and similar therapeutic models, the thoughts and feelings that triggered the actions leading to the relapse must be clearly defined and understood. Therefore, chronicling details of each relapse is an effective way to learn one’s patterns of thoughts and behavior. Below is a set of questions that can be of use to somebody trying to abstain from a relapse to any addictive behavior, and is also a form of practicing CBT (Marlatt; Gordon 1985).

  • What time of day did you use?
  • Where did you use?
  • How much alcohol or drugs did you use?
  • How often did you use it?
  • What did you want alcohol and/or drug use to accomplish?
  • What were the real consequences, positive and negative, of your use? In other words, did the booze and drugs do for you what you wanted it to do during each period of your life? (Marlatt; Gordon 1985)

Using operant conditioning for relapse prevention

Addiction is a learned behavior because the initial pleasure or enjoyment was rewarding. Most substances that people become addicted to offer an immediate reward. Studies show that when behavior is immediately rewarded, people and animals learn and recognize this reward more quickly. When dealing with addiction, the activities that were once rewarding to a person become less rewarding, as the need for a substance takes over. By utilizing operant conditioning, an addicted person can learn how he or she can be rewarded by making healthier choices. The choices must hold value and significant meaning to the addicted person in order for the system to work.

Just as positive reinforcement would be received from using drugs or alcohol, contrastingly reward can also be found in peer acceptance, positive reinforcement when someone is in recovery. The trick is to keep track of the positive reinforcement experienced due to sobriety, which could not be experienced from using or drinking (Miller; Meyers; Hiller-Sturmhofel 1999).

For example, when using or drinking heavily true friendships are very hard to come by. However, when sober one has the opportunity to experience real connections with other human beings without the use of drugs or alcohol as an inhibitor. These relationships can turn into life-long friendships that are built on trust, personal dignity and honesty.

Community reinforcement and family training (CRAFT)

CRAFT relies on operant conditioning principles. This model of treatment teaches friends and family members to reward the addicted person’s positive and healthy behaviors, and punish his or her negative behaviors. Research has shown that addicted people can maintain sobriety much longer when they expect a reward, rather than a punishment (Miller; Meyers; Hiller-Sturmhofel 1999).

Community reinforcement approach (CRA) for overcoming alcoholism or drug addiction is based on the operant conditioning philosophy, which holds that eliminating positive reinforcement for drinking and using and enhancing it for sobriety can be done by rearranging a person’s life so that abstinence becomes more rewarding than drinking or using (Miller; Meyers; Hiller-Sturmhofel 1999).

According to CRA, negative reinforcement can also be used to achieve sobriety. One method is to confront the person with unpleasant consequences of drinking or using. This approach attempts to use aversion therapies and the infliction of negative consequences for the drinking or using (Miller 1998).
For those struggling with addiction, an effective treatment program and relapse prevention plan can make a world of difference. If you or a loved one would like more information on obtaining treatment for an addiction to drugs or alcohol, you can call the Recovery Helpline at 855-441-4405.

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